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   RE: 2018 MIPS will omit MDs less than $90,000 or 200 Medicare patients
 From: Peter Liepmann
 To: Member Forum
 Posted: 06-26-2017 18:14
 Message: Mike,
I find CMS/MIPS/MU  not just confusing, but bewildering and baffling.  FWIW, I think you've made the right decision, because the amount of time and grief it would cost you is likely more than it's worth.  E.g., cost of doing MU, $15,000 (minimum) to $100,000 (other estimates) vs.  5% of $50,000 = $2,500, so you'd be spending $15-50,000 to save $2500.  Sounds like HealthLink Partners!

I looked you up on CMS's site
https://qpp.cms.gov/participation-lookup?npi=1407994916#summary
and I'm not sure the results make sense.  I would think the Residency would bill under their group #, but...???
The only 'group' that gets you over $30,000 is Sawkill....

It looks like you have less than $30,000 in MCR charges in your private practice, so you may want to appeal/argue with them (CMS).
If the residency is using your NPI to bill for their residents/NPs/PAs, you may want to talk with them too!

To evade the penalty for 2019 report one measure: https://static.helpjuice.com/helpjuice_production/uploads/upload/image/2190/93725/MIPS_EvadePenalty_MX.pdf
is a cheat sheet on this-I uploaded it to the library too, in case it disappears.

Then the next question is about that APM- is that an Advanced APM, or just a plain old MIPS APM??  If it's an Advanced APM, then they'll have whatever measures they decide to report, but if it's a plain old MIPS APM, you report MIPS anyway.  See how simple?

My head spins.

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Peter Liepmann MD FAAFP MBA
My mission is to fix US health care www.PCMHpcc.com
Bakersfield CA
5183026006
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Original Message:
Sent: 06-25-2017 10:47
From: Michael Safran
Subject: 2018 MIPS will omit MDs less than $90,000 or 200 Medicare patients

Peter,
I am MIPS naive.   I few years ago I decided not to do MU, PQRS, etc.   I was tired of spending New Years eve doing chart reviews and submitting data. I made the decision that my time at home was more valuable to me then the penalties and bonuses.

I did join an APM last year that seems to mine the data for me without effort on my behalf, so hope to eliminate the penalties starting in 2018, that  I have incurred.    (Currently at least 5%)

I apologize if my question shows ignorance, and it may not apply to me since I am in a APM.  When you say a doctor with a small practice is excluded from MIPS....

Do you mean they will not need to participate in 2018 to avoid a reduction in payment in 2020
OR
Is there some bonus that they are ineligible for.

Thanks,
Mike S.

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Michael S. MD
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Original Message:
Sent: 06-21-2017 13:29
From: Peter Liepmann
Subject: 2018 MIPS will omit MDs less than $90,000 or 200 Medicare patients

The Centers for Medicare and Medicaid Services (CMS) intends to further raise the threshold for participation in its Merit-Based Incentive Payment System (MIPS). In its much-anticipated proposed 2018 rule for the Quality Payment Program (QPP), which was released today, CMS proposed to increase the threshold to exclude MIPS-eligible clinicians or groups with $90,000 or less in Part B-allowed Medicare charges or 200 or fewer Part B Medicare beneficiaries.

The threshold applies to the 2018 performance year, in which the scores of MIPS-eligible clinicians will determine their negative or positive payment adjustments in 2020. In the 2017 performance year, which determines payment adjustments in 2019, individual MIPS-eligible clinicians or groups with $30,000 or less in Part B-allowed charges or 100 or fewer beneficiaries are exempted from MIPS.

http://www.medscape.com/viewarticle/881875?nlid=115977_3901&src=wnl_newsalrt_170620_MSCPEDIT&uac=95699BV&impID=1372295&faf=1

Of course, being in an APM, like Jean's, would exempt you from MIPS as well.
Good news for all.



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Peter Liepmann MD FAAFP MBA
My mission is to fix US health care www.PCMHpcc.com
Bakersfield CA
5183026006
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